<div id="tempdrug_purchases">			
		<form class="form-horizontal main-form form-border" role="form">
			
			
				
				<div class="row row-border">
					<div class="col-md-2 border-label">
						<label class="control-label">具体事项</label>
					</div>
					<div class="col-md-10 border-left">
						<input type="text" class="form-control border-none" id="name" name="name" readonly/>
					</div>
				</div>
				
				<div class="row row-border">      
					<div class="col-md-2 border-label">
						<label class="control-label">申请日期</label>
					</div>
			
					<div class="col-md-10 border-left">
						<div class="col-md-5 no-padding">
							<input type="text" class="form-control border-none" id="apply_date" name="apply_date" readonly/>
						</div>
					  
			
						<div class="col-md-7 border-left">
							<div class="col-md-3 border-label">
								<label class="control-label">业务编号</label>
							</div>
							<div class="col-md-9 border-left">
								<input type="text" class="form-control border-none" id="bizno" name="bizno" readonly/>
							</div>
						</div>
					</div>
				</div>
					
				<div class="row row-border">      
					<div class="col-md-2 border-label">
						<label class="control-label">申请科室</label>
					</div>
			
					<div class="col-md-10 border-left">
						<div class="col-md-5 no-padding">
							<input type="text" class="form-control border-none" id="apply_deptname" name="apply_deptname" readonly/>
						</div>		  
			
						<div class="col-md-7 border-left">
							<div class="col-md-3 border-label">
								<label class="control-label">申请人员</label>
							</div>
							<div class="col-md-9 border-left">
								<input type="text" class="form-control border-none" id="apply_name" name="apply_name" readonly/>
							</div>
						</div>
					</div>
				</div>		
				
				
				<div class="row row-border">      
					<div class="col-md-2 border-label">
						<label class="control-label">患者姓名</label>
					</div>
			
					<div class="col-md-10 border-left">
						<div class="col-md-5 no-padding">
							<input type="text" class="form-control border-none" id="patient_name" name="patient_name" readonly/>
						</div>		  
			
						<div class="col-md-7 border-left">
							<div class="col-md-3 border-label">
								<label class="control-label">患者性别</label>
							</div>
							<div class="col-md-9 border-left">
								<div class="col-md-1">
								</div>
								<div class="col-md-11">
									<div class="radio-inline">
									  <label>
									    <input type="radio" name="sex" id="sex1" value="男" checked>男
									  </label>
									</div>
									<div class="radio-inline">
									  <label>
									    <input type="radio" name="sex" id="sex2" value="女">女
									  </label>
									</div>
								</div>
							</div>
						</div>
					</div>
				</div>
						
				<div class="row row-border">      
					<div class="col-md-2 border-label">
						<label class="control-label">患者年龄</label>
					</div>
			
					<div class="col-md-10 border-left">
						<div class="col-md-5 no-padding">
							<input type="text" class="form-control border-none" id="age" name="age" readonly/>
						</div>		  
			
						<div class="col-md-7 border-left">
							<div class="col-md-3 border-label">
								<label class="control-label">住院科别</label>
							</div>
							<div class="col-md-9 border-left">
								<input type="text" class="form-control border-none" id="room_dept" name="room_dept" readonly/>
							</div>
						</div>
					</div>
				</div>
				
					
				<div class="row row-border">
					<div class="col-md-2 border-label">
						<label class="control-label">诊断</label>
					</div>
					<div class="col-md-10 border-left">
						<textarea  class="form-control border-none" id="diagnose" name="diagnose" rows="5"/>
					</div>
				</div>
				
				<div class="row row-border">      
					<div class="col-md-2 border-label">
						<label class="control-label">药品通用名</label>
					</div>
			
					<div class="col-md-10 border-left">
						<div class="col-md-5 no-padding">
							<input type="text" class="form-control border-none" id="drug_name" name="drug_name" readonly/>
						</div>		  
			
						<div class="col-md-7 border-left">
							<div class="col-md-3 border-label">
								<label class="control-label">药品商用名</label>
							</div>
							<div class="col-md-9 border-left">
								<input type="text" class="form-control border-none" id="recommend" name="recommend" readonly/>
							</div>
						</div>
					</div>
				</div>
				
				<div class="row row-border">      
					<div class="col-md-2 border-label">
						<label class="control-label">基本药物</label>
					</div>
			
					<div class="col-md-10 border-left">
						<div class="col-md-5 no-padding">
							<div class="col-md-1">
							</div>
							<div class="col-md-11">
								<div class="radio-inline">
								  <label>
								    <input type="radio" name="base_drug" id="base_drug1" value="1" checked>是
								  </label>
								</div>
								<div class="radio-inline">
								  <label>
								    <input type="radio" name="base_drug" id="base_drug2" value="0">否
								  </label>
								</div>
							</div>
						</div>		  
			
						<div class="col-md-7 border-left">
							<div class="col-md-3 border-label">
								<label class="control-label">招标品种</label>
							</div>
							<div class="col-md-9 border-left">
								<div class="col-md-1">
								</div>
								<div class="col-md-11">
									<div class="radio-inline">
									  <label>
									    <input type="radio" name="apply_drug" id="apply_drug1" value="1" checked>是
									  </label>
									</div>
									<div class="radio-inline">
									  <label>
									    <input type="radio" name="apply_drug" id="apply_drug2" value="0">否
									  </label>
									</div>
								</div>
							</div>
						</div>
					</div>
				</div>
				
				
				<div class="row row-border">      
					<div class="col-md-2 border-label">
						<label class="control-label">农合目录</label>
					</div>
			
					<div class="col-md-10 border-left">
						<div class="col-md-5 no-padding">
							<div class="col-md-1">
							</div>
							<div class="col-md-11">
								<div class="radio-inline">
								  <label>
								    <input type="radio" name="longhe_drug" id="longhe_drug1" value="1" checked>是
								  </label>
								</div>
								<div class="radio-inline">
								  <label>
								    <input type="radio" name="longhe_drug" id="longhe_drug2" value="0">否
								  </label>
								</div>
							</div>
						</div>		  
			
						<div class="col-md-7 border-left">
							<div class="col-md-3 border-label">
								<label class="control-label">医保等级</label>
							</div>
							<div class="col-md-9 border-left">
								<div class="col-md-1">
								</div>
								<div class="col-md-11">
									<div class="radio-inline">
									  <label>
									    <input type="radio" name="medical_insurance" id="medical_insurance1" value="1" checked>甲级
									  </label>
									</div>
									<div class="radio-inline">
									  <label>
									    <input type="radio" name="medical_insurance" id="medical_insurance2" value="0">乙级
									  </label>
									</div>
								</div>
							</div>
						</div>
					</div>
				</div>	
				
				
				<div class="row row-border">      
					<div class="col-md-2 border-label">
						<label class="control-label">药品剂型</label>
					</div>
			
					<div class="col-md-10 border-left">
						<div class="col-md-5 no-padding">
							<select type="text" class="form-control border-none" name="drug_kind" id="drug_kind" readonly>
								<option value="1">口服液体剂</option>
								<option value="2">外用液体剂</option>
								<option value="3">口服散剂</option>
								<option value="4">外用散剂</option>
								<option value="5">软膏剂</option>
								<option value="6">硬膏剂</option>
								<option value="7">吸入剂</option>
								<option value="8">注射剂</option>
								<option value="9">凝胶剂</option>
								<option value="10">颗粒剂</option>
								<option value="11">胶囊剂</option>
								<option value="12">片剂</option>
								<option value="13">粉剂</option>
								<option value="14">散剂</option>
								<option value="15">丸剂</option>
								<option value="16">栓剂</option>
								<option value="17">滴剂</option>
								<option value="18">贴剂</option>
								<option value="19">涂剂</option>
								<option value="20">洗剂</option>
							</select>
						</div>		  
			
						<div class="col-md-7 border-left">
							<div class="col-md-3 border-label">
								<label class="control-label">药品规格</label>
							</div>
							<div class="col-md-9 border-left">
								<input type="text" class="form-control border-none" id="format" name="format" readonly/>
							</div>
						</div>
					</div>
				</div>
				
				
				<div class="row row-border">      
					<div class="col-md-2 border-label">
						<label class="control-label">申请数量</label>
					</div>
			
					<div class="col-md-10 border-left">
						<div class="col-md-5 no-padding">
							<input type="text" class="form-control border-none" id="amount" name="amount" readonly/>
						</div>		  
			
						<div class="col-md-7 border-left">
							<div class="col-md-3 border-label">
								<label class="control-label">药品价格</label>
							</div>
							<div class="col-md-8 border-left">
								<input type="text" class="form-control border-none" id="price" name="price" readonly/>
							</div>
							<div class="col-md-1 border-label">
								<label class="control-label">元</label>
							</div>
						</div>
					</div>
				</div>
				
				<div class="row row-border">      
					<div class="col-md-2 border-label">
						<label class="control-label">生产厂家</label>
					</div>
			
					<div class="col-md-10 border-left">
						<div class="col-md-5 no-padding">
							<input type="text" class="form-control border-none" id="producer" name="producer" readonly/>
						</div>		  
			
						<div class="col-md-7 border-left">
							<div class="col-md-3 border-label">
								<label class="control-label">经销商电话</label>
							</div>
							<div class="col-md-9 border-left">
								<input type="text" class="form-control border-none" id="angency_phone" name="angency_phone" readonly/>
							</div>
						</div>
					</div>
				</div>
							
				<div class="row row-border">      
					<div class="col-md-2 border-label">
						<label class="control-label">同类产品</label>
					</div>
			
					<div class="col-md-10 border-left">
						<div class="col-md-5 no-padding">
							<div class="col-md-1">
							</div>
							<div class="col-md-11">
								<div class="radio-inline">
								  <label>
								    <input type="radio" name="replacement" id="replacement1" value="1" >有
								  </label>
								</div>
								<div class="radio-inline">
								  <label>
								    <input type="radio" name="replacement" id="replacement2" value="0" checked>无
								  </label>
								</div>
							</div>
						</div>		  
			
						<div class="col-md-7 border-left">
							<div class="col-md-3 border-label">
								<label class="control-label">同类产品名称</label>
							</div>
							<div class="col-md-9 border-left">
								<input type="text" class="form-control border-none" id="replacement_drug" name="replacement_drug" readonly/>
							</div>
						</div>
					</div>
				</div>
				
				
				<div class="row row-border">
					<div class="col-md-2 border-label">
						<label class="control-label">申请理由</label>
					</div>
					<div class="col-md-10 border-left">
						<textarea  class="form-control border-none" id="apply_content" name="apply_content" rows="5"/>
					</div>
				</div>
				
				
				<!-- 科室意见 -->
				<div class="row row-border">
					
					<div class="col-md-2 border-label">
						<label class="control-label">科室意见</label>
					</div>
					<div class="col-md-10 border-left">
						<textarea  class="form-control border-none sign-control" id="dept_content" rows="5" name="dept_content" readonly></textarea>
			
						
						<div class="col-md-2"></div>
						<div class="col-md-5">
							<div class="col-md-4">
								<label class="control-label">签名</label>
							</div>
							<div class="col-md-8">
								<input type="text" class="form-control border-none sign-user" id="deptaudit_name" name="deptaudit_name" readonly/>
							</div>
						</div>
						<div class="col-md-5">
							<div class="col-md-4">
								<label class="control-label">时间</label>
							</div>
							<div class="col-md-8">
								<input type="text" class="form-control border-none sign-time" id="deptaudit_time" name="deptaudit_time" readonly/>
							</div>
						</div>
					
					</div>
					
				</div>			
				<!-----                 ---------------->
				<!-- 临床药学意见 -->
				<div class="row row-border">
					
					<div class="col-md-2 border-label">
						<label class="control-label">临床药学<br>审核意见</label>
					</div>
					<div class="col-md-10 border-left">
						<textarea  class="form-control border-none sign-control" id="biz_content" rows="5" name="biz_content" readonly></textarea>
			
						
						<div class="col-md-2"></div>
						<div class="col-md-5">
							<div class="col-md-4">
								<label class="control-label">签名</label>
							</div>
							<div class="col-md-8">
								<input type="text" class="form-control border-none sign-user" id="biz_name" name="biz_name" readonly/>
							</div>
						</div>
						<div class="col-md-5">
							<div class="col-md-4">
								<label class="control-label">时间</label>
							</div>
							<div class="col-md-8">
								<input type="text" class="form-control border-none sign-time" id="biz_time" name="biz_time" readonly/>
							</div>
						</div>
					
					</div>
					
				</div>			
					
				<!-----                 ---------------->
				
				<!-- 医务科意见 -->
				<div class="row row-border">
					
					<div class="col-md-2 border-label">
						<label class="control-label">医务科<br>审核意见</label>
					</div>
					<div class="col-md-10 border-left">
						<textarea  class="form-control border-none sign-control" id="audit_content" rows="5" name="audit_content" readonly></textarea>
			
						
						<div class="col-md-2"></div>
						<div class="col-md-5">
							<div class="col-md-4">
								<label class="control-label">签名</label>
							</div>
							<div class="col-md-8">
								<input type="text" class="form-control border-none sign-user" id="audit_name" name="audit_name" readonly/>
							</div>
						</div>
						<div class="col-md-5">
							<div class="col-md-4">
								<label class="control-label">时间</label>
							</div>
							<div class="col-md-8">
								<input type="text" class="form-control border-none sign-time" id="audit_time" name="audit_time" readonly/>
							</div>
						</div>
					
					</div>
					
				</div>	
				
				
				<!-- 药剂科意见 -->
				<div class="row row-border">
					
					<div class="col-md-2 border-label">
						<label class="control-label">药剂科<br>审核意见</label>
					</div>
					<div class="col-md-10 border-left">
						<textarea  class="form-control border-none sign-control" id="drug_content" rows="5" name="drug_content" readonly></textarea>
			
						
						<div class="col-md-2"></div>
						<div class="col-md-5">
							<div class="col-md-4">
								<label class="control-label">签名</label>
							</div>
							<div class="col-md-8">
								<input type="text" class="form-control border-none sign-user" id="drugAudit_name" name="drugAudit_name" readonly/>
							</div>
						</div>
						<div class="col-md-5">
							<div class="col-md-4">
								<label class="control-label">时间</label>
							</div>
							<div class="col-md-8">
								<input type="text" class="form-control border-none sign-time" id="drugAudit_time" name="drugAudit_time" readonly/>
							</div>
						</div>
					
					</div>
					
				</div>
				
				<!-- 业务分管院长意见 -->
				<div class="row row-border">
					
					<div class="col-md-2 border-label">
						<label class="control-label">业务分管<br/>院长意见</label>
					</div>
					<div class="col-md-10 border-left">
						<textarea  class="form-control border-none sign-control" id="chargeLeader_content" rows="5" name="chargeLeader_content" readonly></textarea>
			
						
						<div class="col-md-2"></div>
						<div class="col-md-5">
							<div class="col-md-4">
								<label class="control-label">签名</label>
							</div>
							<div class="col-md-8">
								<input type="text" class="form-control border-none sign-user" id="chargeLeader_name" name="chargeLeader_name" readonly/>
							</div>
						</div>
						<div class="col-md-5">
							<div class="col-md-4">
								<label class="control-label">时间</label>
							</div>
							<div class="col-md-8">
								<input type="text" class="form-control border-none sign-time" id="chargeLeader_time" name="chargeLeader_time" readonly/>
							</div>
						</div>
					
					</div>
					
				</div>
				
										
				<input name="id" id="id" type="hidden" />
				<input name="bizid" id="bizid" type="hidden" />
				<input name="flowInstId" id="flowInstId" type="hidden" />
				<input name="flowTaskId" id="flowTaskId" type="hidden" />
				<input name="created" id="created" type="hidden" />
				<input name="creater" id="creater" type="hidden" />


				<input name="apply_id" id="apply_id" type="hidden" />
				<input id="apply_deptid" name="apply_deptid" type="hidden" />
				<input id="deptaudit_id" name="deptaudit_id" type="hidden" />
				<input id="audit_id" name="audit_id" type="hidden" />
				<input id="biz_id" name="biz_id" type="hidden" />
				<input id="drug_id" name="drug_id" type="hidden" />
				<input id="chargeLeader_id" name="chargeLeader_id" type="hidden" />
				
				<input id="dept_audit_deptid" name="dept_audit_deptid" type="hidden" />
				<input id="dept_audit_deptname" name="dept_audit_deptname" type="hidden" />

			
		</form>
</div>
<script>

requirejs(['oaMain','domReady!'],function(flowedit,doc){
	flowedit.initEdit({initElement:null});
})
</script>

